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Arkew M, Asmerom H, Gemechu K, Tesfa T. Global Prevalence of Anemia Among Type 2 Diabetic Adult Patients: A Systematic Review and Meta-Analysis. Diabetes Metab Syndr Obes 2023; 16:2243-2254. [PMID: 37545742 PMCID: PMC10402722 DOI: 10.2147/dmso.s421851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023] Open
Abstract
Background Anemia is a common and often overlooked hematological change observed in patients with diabetes mellitus. However, there is no global survey or health registry that estimates the pooled prevalence of anemia in patients with type 2 diabetes. Therefore, this study aimed to determine the global pooled prevalence of anemia among adult patients with type 2 diabetes. Methods This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. The study protocol was registered on PROSPERO with the reference number (CRD42022327135), and the link provided (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022327135) display the published methodology. Previously published articles were searched in PubMed/Medline, Cochrane Library, WHO Global Index Medicus, African Journals Online, ScienceDirect, Google Scholar, and Google from October 26 to November 09, 2022. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal tool. Random-effects model was used to estimate the pooled prevalence of anemia. The degree of heterogeneity among the included studies was assessed using I2 statistics. Publication bias was detected using funnel plot symmetry analysis supplemented by Egger's and Begg's tests. Results Twenty-four studies with a total number of 19,118 participants were included in this systematic review and meta-analysis. The overall pooled prevalence of anemia among type 2 diabetic adult patients was 27.0% (95% CI: 24.0, 31.0, I2 = 96.45%; P< 0.001). Geographical and time-based subgroup analysis showed that higher prevalence of anemia was observed in Africa region 28.0% (95% CI: 17.0, 39.0) and from 2015 to 2022, 28.0% (95% CI: 24.0, 33.0), respectively. Conclusion Anemia is a moderate public health problem among adult patients with type 2 diabetes. Nearly one in four patients with type 2 diabetes develops anemia. Therefore, considering the negative impact of anemia, it is important to include anemia screening in the routine assessment of diabetes-related complications.
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Affiliation(s)
- Mesay Arkew
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Haftu Asmerom
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Gemechu
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tewodros Tesfa
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Hizomi Arani R, Fakhri F, Naeimi Tabiee M, Talebi F, Talebi Z, Rashidi N, Zahedi M. Prevalence of anemia and its associated factors among patients with type 2 diabetes mellitus in a referral diabetic clinic in the north of Iran. BMC Endocr Disord 2023; 23:58. [PMID: 36894956 PMCID: PMC9997001 DOI: 10.1186/s12902-023-01306-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 02/18/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND PURPOSE: This study intended to investigate the prevalence of anemia and its associated factors among patients with type 2 diabetes mellitus (T2DM) in Gorgan, Iran. METHODS This cross-sectional study was conducted on 415 (109 men) patients with T2DM referred to the referral diabetes clinic of Sayad Shirazi Hospital in Gorgan in 2021. Demographic information, anthropometric indices, past medical history, and some laboratory data on cell counts, serum blood glucose, HbA1c, creatinine, lipid/iron profiles, and urinary albumin were collected. The univariable and multivariable logistic regression analysis was applied to compute odds ratios (ORs) and 95% confidence intervals (CI) for potential associated factors, using SPSS version 21. The multivariable Model was adjusted for obesity, Hb A1c, T2DM duration, using glucose-lowering drugs (GLDs), chronic kidney disease (CKD), albuminuria, hypertriglyceridemia, and hypercholesterolemia. RESULTS: The prevalence of anemia was 21.5% [95%CI: 17.6-25.7] among our total participants. The corresponding values for men and women were 20.2 (13.1-29.0) and 21.9 (17.4-27.0), respectively.The adjusted model revealed that obesity (OR, 1.94 [95% CI, 1.17-3.23]), T2DM duration for more than five years (OR, 3.12 [1.78-5.47]), albuminuria (OR, 6.37 [3.13-10.91]), chronic kidney disease (OR, 4.30 [ 2.83-7.29]) and hypertriglyceridemia (OR, 1.72 [ 1.21-2.77]) were significantly associated with prevalent anemia among patients with T2DM. Moreover, using insulin separately or in combination with oral GLDs associated positively with the prevalence of anemia with ORs of 2.60 [1.42-6.42] and 1.87 [1.30-4.37] , respectively. CONCLUSION Anemia had a high prevalence among patients with T2DM in the north of Iran (about 22%), which is associated with obesity, hypertriglyceridemia, duration of T2DM, and diabetic kidney disease.
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Affiliation(s)
- Reyhane Hizomi Arani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farima Fakhri
- Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Kerman University of Medical Science, 7616913555, Kerman, Iran
| | - Mohammad Naeimi Tabiee
- Department of Internal Medicine, Hematology and Oncology disorders, Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Talebi
- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Zahra Talebi
- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Negin Rashidi
- Institute of Medical Science, University of Toronto, Toronto, CA, Canada
| | - Maryam Zahedi
- Department of Internal Medicine, Endocrinology and metabolic disorders, Clinical Research Development Unit (CRDU), Sayyad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran.
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Taderegew MM, Wondie A, Terefe TF, Tarekegn TT, GebreEyesus FA, Mengist ST, Amlak BT, Emeria MS, Timerga A, Zegeye B. Anemia and its predictors among chronic kidney disease patients in Sub-Saharan African countries: A systematic review and meta-analysis. PLoS One 2023; 18:e0280817. [PMID: 36730249 PMCID: PMC9894480 DOI: 10.1371/journal.pone.0280817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/09/2023] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Anemia is a serious complication of chronic kidney disease (CKD) with a significant adverse outcome on the burden and progression of the disease. Hence, the study intended to assess the pooled prevalence of anemia and its predictors among CKD patients in Sub-Saharan African nations. METHODS To identify the relevant studies systematic searches were carried out in Medline, EMBASE, HINARI, Google Scholar, Science Direct, and Cochrane Library. From selected studies, data were taken out with a standardized data extraction format prepared in Microsoft Excel. Inverse variance (I2) tests were employed to evaluate the heterogeneity across the included studies. Due to substantial heterogeneity among the studies, a random-effects meta-analysis technique was employed to estimate the pooled prevalence of anemia. Subgroup analysis, sensitivity analysis, and meta-regression analysis were carried out to search the possible bases of heterogeneity. Funnel plot symmetry, Begg's test, and Egger's regression test were employed to assess the existence of publication bias. In addition, factors associated with anemia among CKD patients were examined. All statistical analyses were carried out with STATA™ Version 14 software. RESULTS A total of 25 studies with 5042 study participants were considered in this study. The pooled prevalence of anemia among CKD patients was estimated to be 59.15% (95% CI, 50.02-68.27) with a substantial level of heterogeneity as evidenced by I2 statistics (I2 = 98.1%; p < 0.001). Stage of CKD (3-5) (pooled odds ratio (POR) = 5.33, 95% CI:4.20-6.76), presence of diabetes mellitus (POR = 1.75, 95% CI: 1.10-2.78), hemodialysis history (POR = 3.06, 95% CI: 1.63-5.73), and female sex (POR = 2.50, 95% CI: 1.76-3.55) were significantly related with anemia. CONCLUSIONS More than half of CKD patients were suffering from anemia. Stage of CKD, presence of DM, hemodialysis history, and being female sex were factors associated with anemia among CKD patients.
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Affiliation(s)
- Mitku Mammo Taderegew
- Department of Biomedical Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia,* E-mail:
| | - Alemayehu Wondie
- Department of Biomedical Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Tamene Fetene Terefe
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Tadesse Tsehay Tarekegn
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Fisha Alebel GebreEyesus
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Shegaw Tesfa Mengist
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Baye Tsegaye Amlak
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Mamo Solomon Emeria
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Abebe Timerga
- Department of Biomedical Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Betregiorgis Zegeye
- HaSET Maternal and Child Health Research Program, Shewarobit Field Office, Shewarobit, Ethiopia
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Getawa S, Adane T. Hematological abnormalities among adults with type 1 diabetes mellitus at the University of Gondar Comprehensive Specialized Hospital. SAGE Open Med 2022; 10:20503121221094212. [PMID: 35492887 PMCID: PMC9047808 DOI: 10.1177/20503121221094212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/23/2022] [Indexed: 11/24/2022] Open
Abstract
Objective: Changes in the blood cell function, metabolism, and the coagulation system
were associated with diabetes mellitus. This study aimed to determine the
magnitude and associated factors of hematological abnormalities in adults
with type 1 diabetes mellitus. Methods: A total of 204 medical charts of adults with type 1 diabetes mellitus who
registered for follow-up at the University of Gondar Comprehensive
Specialized Hospital were reviewed from June to August 2021. Data were
collected using a structured data extraction checklist. To identify factors
associated with hematological abnormalities, both bivariate and multivariate
logistic regression analyses were done. Statistical significance was defined
as a p-value of <0.05. Results: The overall magnitude of leukocytosis and anemia in adults with type 1
diabetes mellitus was 76.0% (95% confidence interval: 70.07–81.89) and
30.90% (95% confidence interval: 24.49–37.28), respectively. Neutrophilia
and lymphocytosis were the common white blood cell abnormalities detected in
53.43% (95% confidence interval: 46.53–60.33) and 43.63% (95% confidence
interval: 36.76–50.49) of the patients, respectively. Besides,
thrombocytosis and thrombocytopenia were observed in 5.4% (95% confidence
interval: 2.27–8.52) and 10.3% (95% confidence interval: 6.09–14.5) of the
patients, respectively. Only being male (adjusted odds ratio = 2.28 (95%
confidence interval: 1.46–5.29)) and duration of diabetes mellitus
(⩾3 years) (adjusted odds ratio = 8.41 (95% confidence interval:
2.49–28.29)) were significantly associated with anemia and leukocytosis,
respectively. Conclusion: Hematological abnormalities, particularly anemia and leukocytosis, are common
in patients with type 1 diabetes mellitus. Therefore, preventive and control
strategies for hematological abnormalities are essential in patients with
type 1 diabetes mellitus particularly for male and patients with a long
duration on diabetes mellitus to reduce the burden and related
complications.
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Affiliation(s)
- Solomon Getawa
- Solomon Getawa, Department of Hematology
and Immunohematology, School of Biomedical and Laboratory Sciences, College of
Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Olum R, Bongomin F, Kaggwa MM, Andia-Biraro I, Baluku JB. Anemia in diabetes mellitus in Africa: A systematic review and meta-analysis. Diabetes Metab Syndr 2021; 15:102260. [PMID: 34479102 DOI: 10.1016/j.dsx.2021.102260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/04/2021] [Accepted: 08/17/2021] [Indexed: 12/11/2022]
Abstract
AIMS Anemia accelerates chronic complications of diabetes mellitus (DM). We aimed to conduct a systematic review and meta-analysis to estimate the prevalence of anemia among people with DM in Africa. METHODS A search of studies was conducted in the main databases (Medline, EMBASE, Scopus, CINAHL, AJOL and Google Scholar) and the reference lists of selected studies. Observational studies that met the eligibility criteria were included in this meta-analysis. There was no limitation in terms of language. RESULTS We obtained data from 27 eligible studies, including 5913 patients. The pooled prevalence of anemia was 35% (95% CI: 28%-42%, I2 = 97.7%, p < 0.01). In sub-group analysis, the pooled prevalence was higher in people with diabetic foot lesions (56%, 95% CI: 49%-63%, I2 = 51.04%, p = 0.100) than in the general population of people with diabetes (30%, 95% CI: 23%-37%, I2 = 97.6%, p < 0.01). Pooled prevalence rates were also higher in; males than females (34% vs 31%), type II DM than type I DM (35% vs 26%), and in patients with poor glycemic control compared to those with good glycemic control (33% vs. 22%). CONCLUSIONS The prevalence of anemia in DM was high warranting enhanced clinical and public health interventions.
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Affiliation(s)
- Ronald Olum
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Felix Bongomin
- Department of Medical Microbiology & Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.
| | - Mark Mohan Kaggwa
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Irene Andia-Biraro
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda; Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
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Atlaw D, Tariku Z. Magnitude and factors associated with anemia among diabetic patients in Ethiopia: A systematic review and meta-analysis. SAGE Open Med 2021; 9:20503121211031126. [PMID: 34290867 PMCID: PMC8274127 DOI: 10.1177/20503121211031126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/21/2021] [Indexed: 12/16/2022] Open
Abstract
Background: In Ethiopia, diabetes is estimated to affect about half a million people. About 35% of individuals with diabetes are complicated by microvascular diseases like retinopathy, nephropathy, cardiovascular, and anemia. Even though there are some studies conducted on prevalence and associated factors of anemia in diabetic patients, their findings were variable. Therefore, this meta-analysis is aimed to determine the pooled prevalence and factors associated with anemia among diabetic patients. Methods: PubMed, CINAHL, POPLINE, ScienceDirect, African Journals Online, and Google Scholar were systematically searched to identify related studies. The heterogeneity of studies was assessed using Cochran’s Q test and I2 tests. A random-effects model was used to estimate the pooled prevalence of anemia among diabetic patients in Ethiopia. Publication bias was evaluated by employing Egger’s tests. Results: After reviewing 503 articles, 6 articles fulfilled inclusion criteria and remained for the final meta-analysis. The pooled prevalence of anemia among diabetic patients was 24.81% (95% confidence interval: 19.38–30.25). Age greater than 60 years old (pooled odds ratio, 95% confidence interval: 3.73 (2.23–6.77)), glomerular filtration rate less than 60 mL/min/1.73 m2 (pooled odds ratio, 95% confidence interval: 12.65 (8.71–18.37)), and being diabetic for more than 10 years (pooled odds ratio, 95% confidence interval: 10.21 (7.00–15.04)) were found to be determinants of anemia among diabetic patients in Ethiopia. Conclusion: Overall, one in four diabetic patients develops anemia in Ethiopia. Age, glomerular filtration rate, and duration of being diabetic are factors significantly associated with the occurrence of anemia in diabetic patients.
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Affiliation(s)
- Daniel Atlaw
- Department of Anatomy, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Zerihun Tariku
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
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Adane T, Getawa S. Anaemia and its associated factors among diabetes mellitus patients in Ethiopia: A systematic review and meta-analysis. ENDOCRINOLOGY DIABETES & METABOLISM 2021; 4:e00260. [PMID: 34277984 PMCID: PMC8279623 DOI: 10.1002/edm2.260] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 12/15/2022]
Abstract
Introduction Anaemia is common but often overlooked in diabetes mellitus (DM) patients. There is also no official nationwide survey registry that estimated the prevalence of anaemia in DM patients in Ethiopia. Therefore, the main aim of this study is to determine the countrywide pooled prevalence and associated factors of anaemia in DM patients. Methods This systematic review and meta‐analysis were conducted as per the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. STATA 11 software was used for all statistical analysis. Random effects model was used to estimate the pooled prevalence of anaemia and associated factors at a 95% confidence interval (CI) with its respective odds ratio (OR). Subgroup analysis and egger test were used to determine heterogeneity and publication bias, respectively. Results Nine articles were included in this systematic review and meta‐analysis with a total of 2889 DM patients. The pooled prevalence of anaemia among DM patients in Ethiopia was 22.11% (95% CI: 15.83–28.39) I2 = 94.8%. The prevalence of anaemia in type I and type II DM patients was (16.78% [95% CI: 11.53–22.04]) and (31.12% [95% CI; 9.66–52.58]), respectively. The prevalence of anaemia was higher among male (36.72% [95% CI: 22.58–50.87] I2 = 97.6%) than female (27.51% [95% CI: 16.12–38.90] I2 = 96.3%). Moreover, the odds of anaemia were higher among patients with age ˃ 60 (OR = 2.98; 95% CI: 1.83, 4.87), low estimated glomerular filtration rate (eGFR) (OR = 8.59; 95% CI: 4.76, 15.57), and duration of illness ≥5 years (OR = 2.66; 95%: 1.38, 5.13). Conclusions The result of this review implies that anaemia is a moderate public health problem among DM patients in Ethiopia. Older age, poor glycemic control, low eGFR and longer duration of illness were found to be the contributing factors for the development of anaemia in DM patients. Therefore, by considering the negative impact of anaemia, it is important to include anaemia screening into routine assessment of DM‐related complications targeting patients with older age, poor glycemic control, low eGFR, and longer duration of illness to reduce the magnitude of the problem.
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Affiliation(s)
- Tiruneh Adane
- Department of Hematology and Immunohematology School of Biomedical and Laboratory Sciences College of Medicine and Health Sciences University of Gondar Gondar Ethiopia
| | - Solomon Getawa
- Department of Hematology and Immunohematology School of Biomedical and Laboratory Sciences College of Medicine and Health Sciences University of Gondar Gondar Ethiopia
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Michalak SS, Wolny-Rokicka E, Nowakowska E, Michalak M, Gil L. Clinical Implications of the Coexistence of Anemia and Diabetes Mellitus in the Elderly Population. J Diabetes Res 2021; 2021:8745968. [PMID: 34708130 PMCID: PMC8545586 DOI: 10.1155/2021/8745968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/23/2021] [Accepted: 09/30/2021] [Indexed: 11/18/2022] Open
Abstract
Diabetes mellitus (DM) and also anemia are common in the elderly and have a negative impact on the clinical outcomes of patients. The coexistence of anemia and DM seems to be insufficiently recognized; therefore, the aim of our study is to analyze the incidence and clinical consequences of this coexistence, including mortality, in the population of people aged ≥60. A retrospective study was conducted on 981 primary care clinic patients aged ≥60 during 2013-2014. The prevalence of coexistence of DM and anemia (defined in accordance with WHO) and data on the incidence of comorbidities, hospitalization, medical procedures, and all-cause mortality were analyzed. In the study population, 25% had DM, while 5.4% had both DM and anemia. Peripheral artery disease (PAD) was found in 48 patients (4.89%) of the entire study population, more often in men (p < 0.001). Diabetic patients with anemia compared to nonanemic diabetics had more comorbidities (median 4 (4, 5) vs. 3 (2-4); p < 0.001)-PAD more often (p = 0.004), more hospitalization (median 2 (0-11) vs. 0 (0-11); p < 0.001), and more frequent medical procedures (e.g., percutaneous coronary intervention (p < 0.001), coronary artery bypass surgery (p = 0.027), arteriography (p < 0.001), and bypass surgery or endovascular treatments of lower limb ischemia (p < 0.001)). The cumulative survival of patients with both DM and anemia vs. nonanemic diabetics at 36 months was 86.4% vs. 99.3% (p < 0.001). A multivariate logistic regression model showed anemia to be a significant risk factor for death in diabetic patients (p = 0.013). Patients with both DM and anemia have more comorbidities than nonanemic diabetic patients; they are more often hospitalized, require medical procedures more frequently, and are at a higher risk of death. Effective treatment of anemia in patients with DM is advisable and may well improve the prognosis of patients.
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Affiliation(s)
- S. S. Michalak
- Department of Pharmacology and Toxicology, Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
| | - E. Wolny-Rokicka
- Department of Radiotherapy, Multidisciplinary Hospital, Gorzow Wielkopolski, Poland
| | - E. Nowakowska
- Department of Pharmacology and Toxicology, Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
| | - M. Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - L. Gil
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
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Tujuba T, Ayele BH, Fage SG, Weldegebreal F. Anemia among Adult Diabetic Patients Attending a General Hospital in Eastern Ethiopia: a Cross-sectional Study. Diabetes Metab Syndr Obes 2021; 14:467-476. [PMID: 33564253 PMCID: PMC7866907 DOI: 10.2147/dmso.s289298] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/21/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although anemia is a common condition among patients with diabetes mellitus, there is little evidence on anemia among this segment of population in Ethiopia at large and in the study setting in particular. Thus, this study aimed at assessing the magnitude of anemia and its associated factors among adult diabetic patients attending a general hospital in Eastern Ethiopia. METHODS A health facility-based cross-sectional study was conducted among 325 randomly selected adult diabetes mellitus patients attending a follow-up clinic at Gelemso General Hospital, Eastern Ethiopia. Data were collected through an interview using a pre-tested and structured questionnaire followed by physical and laboratory measurements. Data were then entered into EpiData Version.3.1 and analyzed by using STATA version 16.0. Binary logistic regression models were fitted to identify factors associated with anemia. All statistical tests were declared significant at p-value < 0.05. RESULTS The magnitude of anemia among adult diabetic patients was 30.2% (95% confidence interval (CI): 25.4%-35.4%). Anemia was higher in males (36%) than females (20.5%). Male gender (Adjusted Odds Ratio (AOR) = 2.1, 95% CI: 1.2, 3.8), DM duration of ≥5 years (AOR= 1.9, 95% CI: 1.0, 3.7), presence of comorbidity (AOR= 1.9, 95% CI: 1.0, 3.7), and having diabetic complications (AOR= 2.3, 95% CI: 1.3, 4.2) were significantly associated with anemia. CONCLUSION Anemia was a moderate public health problem among adult DM patients in the study setting. Being male in gender, duration of DM, presence of DM complications, and DM co-morbidities were factors associated with anemia. Therefore, routine screening and appropriate management of anemia targeting males, DM patients with longer duration of DM, and those with complications and co-morbidities should be devised to improve patients' quality of life. Early diagnosis and regular monitoring of DM could also help to minimize further complications.
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Affiliation(s)
- Teshome Tujuba
- Department of Medical Laboratory, Gelemso General Hospital, Gelemso, Ethiopia
| | - Behailu Hawulte Ayele
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Sagni Girma Fage
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Correspondence: Sagni Girma Fage College of Health and Medical Sciences, Haramaya University, P.O.Box 235, Harar, Ethiopia Email
| | - Fitsum Weldegebreal
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Hailu NA, Tolessa T, Gufue ZH, Tsegay EW, Tekola KB. The magnitude of anemia and associated factors among adult diabetic patients in Tertiary Teaching Hospital, Northern Ethiopia, 2019, cross-sectional study. PLoS One 2020; 15:e0240678. [PMID: 33170882 PMCID: PMC7671748 DOI: 10.1371/journal.pone.0240678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 09/30/2020] [Indexed: 12/26/2022] Open
Abstract
Background Patients with Diabetic Mellitus are at higher risk of different complications. Many previous studies show that anemia among diabetic patients is poorly diagnosed. Objective This study aimed to assess the magnitude and associated factors of anemia among adult diabetes patients having regular follow up at the diabetic clinic of Ayder Comprehensive Specialized Hospital, Tigray, 2018/19. Methods This study was conducted the Diabetic clinic of Ayder comprehensive specialized hospital, Tigray regional state, Northern Ethiopia from January to March 2019. A systematic random sampling technique was used to select study participants. About 5 ml of venous blood was collected by experienced laboratory technologists under a complete aseptic technique. Two ml of the venous blood was used for hemoglobin determination. And three ml of the venous blood was used without any anticoagulant for creatinine determination. The association of variables was assessed using bivariate and multivariable analysis in the logistic regression model with p-value, odds ratio, and 95% CI in the SPSS version 24 software. Results From a total of 262 diabetes patients, forty-seven (17.9%) were found to be anemic (6.7% males and 11.5% females). Among the related factors, residency (Adjusted Odds Ratio, 7.69, 95% CI, 2.060, 28.69, p = 0.002,), age of the patients (Adjusted Odds Ratio, 4.007, 95%CI, 1.53–10.51, p = 0.005,) and sex (Adjusted Odds Ratio, 3.434, 95% CI, 1.582, 7.458, p = 0.042,) were significantly associated with anemia. Conclusion According to this study, the magnitude of anemia is high among diabetic patients. Occupation of the participants, residency, HIV status, being female, and age was significantly associated with anemia.
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Affiliation(s)
- Nigus Alemu Hailu
- Biomedical Sciences Department, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
- * E-mail:
| | - Tesfaye Tolessa
- Medical Physiology Department, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zenawi Hagos Gufue
- Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Etsay Weldekidan Tsegay
- Pharmacy Department, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
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Chronic Kidney Disease among Diabetes Patients in Ethiopia: A Systematic Review and Meta-Analysis. Int J Nephrol 2020; 2020:8890331. [PMID: 33101733 PMCID: PMC7569456 DOI: 10.1155/2020/8890331] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/23/2020] [Accepted: 09/26/2020] [Indexed: 11/17/2022] Open
Abstract
Background Though different primary studies have reported the burden of chronic kidney disease among diabetes patients, their results have demonstrated substantial variation regarding its prevalence in Ethiopia. Therefore, this study aimed to estimate the pooled prevalence of chronic kidney disease and its associated factors among diabetes patients in Ethiopia. Method PubMed, African Journals Online, Google Scholar, Scopus, and Wiley Online Library were searched to identify relevant studies. The I2 statistic was used to check heterogeneity across the included studies. A random-effects model was applied to estimate the pooled effect size across studies. A funnel plot and Egger's regression test were used to determine the presence of publication bias. All statistical analyses were performed using STATA™ version 14 software. Result In this meta-analysis, a total of 12 studies with 4,075 study participants were included. The estimated prevalence of CKD among diabetes patients was found to be 35.52% (95% CI: 25.9–45.45, I2 = 96.3%) for CKD stages 1 to 5 and 14.5% (95% CI: 10.5–18.49, I2 = 91.1%) for CKD stages 3 to 5. Age greater than 60 years (OR = 2.99; 95% CI: 1.56–5.73), female sex (OR = 1.68; 95% CI: 1.04–2.69), duration of diabetes >10 years (OR = 2.76; 95% CI: 1.38–5.51), body mass index >30 kg/m2 (OR = 2.06; 95% CI: 1.41–3.00), type 2 diabetes (OR = 2.54; 95% CI: 1.73–3.73), poor glycemic control (OR = 2.01; 95% CI: 1.34–3.02), fasting blood glucose >150 mg/dl (OR = 2.58; 95% CI: 1.79–3.72), high density lipoprotein >40 mg/dl (OR = 0.48; 95% CI: 0.30–0.85–25), systolic blood pressure>140 mmHg (OR = 3.26; 95% CI: 2.24–4.74), and diabetic retinopathy (OR = 4.54; CI: 1.08–25) were significantly associated with CKD. Conclusion This study revealed that the prevalence of chronic kidney disease remains high among diabetes patients in Ethiopia. This study found that a long duration of diabetes, age>60 years, diabetic retinopathy, female sex, family history of kidney disease, poor glycemic control, systolic blood pressure, overweight, and high level of high-density lipoprotein were associated with chronic kidney disease among diabetic patients. Therefore, situation-based interventions and context-specific preventive strategies should be developed to reduce the prevalence and risk factors of chronic kidney disease among diabetes patients.
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Taderegew MM, Gebremariam T, Tareke AA, Woldeamanuel GG. Anemia and Its Associated Factors Among Type 2 Diabetes Mellitus Patients Attending Debre Berhan Referral Hospital, North-East Ethiopia: A Cross-Sectional Study. J Blood Med 2020; 11:47-58. [PMID: 32104127 PMCID: PMC7023873 DOI: 10.2147/jbm.s243234] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 02/04/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Anemia is one of the common complications of diabetes mellitus (DM), which has an adverse effect on the progression and development of other diabetes-related complications. In spite of this, relatively little information is available on the prevalence of anemia and associated factors among type 2 diabetes mellitus (T2DM) patients in Ethiopia, particularly in the study area. Thus, this study assessed the prevalence of anemia and associated factors among T2DM patients at Debre Berhan Referral Hospital (DBRH), North-East, Ethiopia. PATIENTS AND METHODS A hospital-based cross-sectional study was conducted from April 1 to May 30, 2019, among 249 T2DM patients with follow up at DBRH, selected using a systematic random sampling technique. Data were collected by face-to-face interviews, anthropometric measurements, and laboratory tests; such as hemoglobin measurements, red blood indices, and serum creatinine analysis. The data were coded and entered into Epi-data manager version 4.4.1.0, and analysis by using SPSS version 22 was carried out. To identify the determinant factors of anemia, bivariate and multivariate logistic regression analyses were performed. P-value <0.05 was considered as statistically significant. RESULTS The study showed 20.1% of the participants were anemic. Being age >60 years (AOR=3.06, 95% CI: 1.32-7.11), poor glycemic control (AOR=2.95, 95% CI: 1.22-7.15), eGFR 60-89.9 mL/min/1.73m2 (AOR=2.91, 95% CI: 1.15-7.37), eGFR <60 mL/min/1.73m2 (AOR=6.58, 95% CI: 2.42-17.93), DM duration >10 years (AOR= AOR=2.75, 95% CI: 1.17-6.48), and having diabetic complications (AOR=3.81, 95% CI: 1.65-8.81) were significantly associated with anemia. CONCLUSION One out of five T2DM patients had anemia. Poor glycemic control, decreased eGFR, presence of DM complications, duration of DM >10 years, and age >60 years were significantly associated with the occurrence of anemia among T2DM. Regular screening for anemia in all T2DM patients may help in the early detection and management of anemia.
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Affiliation(s)
- Mitku Mammo Taderegew
- Department of Biomedical Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Tewodros Gebremariam
- Department of Biomedical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Amare Abera Tareke
- Department of Biomedical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Gashaw Garedew Woldeamanuel
- Department of Biomedical Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
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Combined administration of exogenous melatonin and insulin ameliorates streptozotocin induced toxic alteration on hematological parameters in diabetic male Wistar rats. Toxicol Rep 2020; 7:353-359. [PMID: 32095432 PMCID: PMC7033445 DOI: 10.1016/j.toxrep.2020.01.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 12/31/2019] [Accepted: 01/29/2020] [Indexed: 02/06/2023] Open
Abstract
The aim of the present was to ameliorate the protective effect of exogenous melatonin and insulin against the diabetes induced alterations in the different hematological variables. Albino rats were administrated streptozotocin at the dose of 15 mg/kg for 6 days. Total 54 rats were randomly selected for the experimental purpose and were divided into two major groups. Group-1 consisting twenty four (24) and were further sub-divided into four (4) different groups viz. group-I served as normal control, group-II served as melatonin treated, group-III served as insulin treated and group-IV served as glibenclamide treated. Group-2 consisting thirty (30) rats were given streptozotocin (STZ) injection (15 mg/kg) for 6 days. After confirmation of diabetes by measuring blood glucose level, animals having blood glucose level above 250 mg/dl) confirmed as diabetic. Thirty (30) Diabetic rats were further subdivided into following sub-groups and were given different therapeutic treatments, Viz group-I served as Diabetic control, group-II treated with melatonin, group-III treated with insulin, group-IV given treatment of melatonin and insulin and group-V were given treatment of glibenclamide respectively. Diabetic rats showed modulation in all the studied hematological variables. Diabetic rats displayed significant decline in RBCs count, HB level and its associated indices (HCT, RDW, MCV, MCH, MCHC), WBCs and its related indices (polymorphs and lymphocytes) and platelet distribution width (PDW %) whereas platelet count showed significant increase. Nonetheless alone as well as combined treatment of exogenous melatonin and insulin restored all altered hematological parameters. However, significant recovery was found in the group in which combined dose of melatonin and insulin was administrated. Therefore, it might be concluded that combined administration of melatonin and insulin will be better remedy to normalize the altered blood profile during the diabetic condition.
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Engidaw MT, Feyisa MS. Prevalence of Anemia and Its Associated Factors Among Adult Diabetes Mellitus Patients at Debre Tabor General Hospital, Northcentral Ethiopia. Diabetes Metab Syndr Obes 2020; 13:5017-5023. [PMID: 33376371 PMCID: PMC7755378 DOI: 10.2147/dmso.s286365] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/02/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Diabetes mellitus is a cluster of metabolic disorders which is characterized by hyperglycemia. The occurrence of anaemia is a significant public health problem among diabetic patients because of complication and dietary modifications. So, this study aimed to assess the magnitude of anaemia among adult diabetes mellitus patients in Debre Tabor General Hospital, Ethiopia. METHODS A cross-sectional study design was conducted. A simple random sampling technique was employed to collect data from 297 adult diabetic mellitus patients. After taking venous blood, the haemoglobin level was determined by using HemoCue 301 machine. Anaemia among diabetic patients was determined by using the haemoglobin level (<13.0g/dL for male and <12.0g/dL for female). Data were entered using EpiInfo version 7.2 and analyzed using SPSS version 21. The binary logistic regression model was used to explore the association of independent variables with anaemia. Finally, p-value <0.05 was used to declare the level of statistical significance. RESULTS The prevalence of anemia among diabetic patient was 29.81% (95% CI: 24.27, 35.35). Diabetic patients unable to read and write (AOR = 3.51, 95% CI: 1.40, 8.75), able to read and write (AOR = 9.76, 95% CI: 3.15, 30.24), ≥4 family size (AOR = 0.53, 95% CI: 0.29, 0.99), intake of flesh meat (AOR=0.19, 95% CI: 0.05, 0.74), and parasitic infections (AOR = 0.26, 95% CI: 0.07, 0.95) were more likely to develop anemia. CONCLUSION Anemia is a moderate public health problem among diabetic patients. Here, educational status, family size, intake of flesh meat, and intestinal parasite infections were the factors associated with the development of anaemia. So, working on these significant factors by health care providers during routine care is vital to prevent anaemia among diabetic patients.
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Affiliation(s)
- Melaku Tadege Engidaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- Correspondence: Melaku Tadege Engidaw Department of Public Health, College of Health Sciences, Debre Tabor University, P.O. Box: 031, Debre Tabor, Ethiopia Email
| | - Mahider Shimelis Feyisa
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Adane T, Getaneh Z, Asrie F. Red Blood Cell Parameters and Their Correlation with Renal Function Tests Among Diabetes Mellitus Patients: A Comparative Cross-Sectional Study. Diabetes Metab Syndr Obes 2020; 13:3937-3946. [PMID: 33122930 PMCID: PMC7591059 DOI: 10.2147/dmso.s275392] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/25/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) patients show a significant derangement in various hematological parameters including changes affecting the red blood cells (RBCs). All these derangements have an imposing effect on any of the RBC indices. Thus, the main aim of this study was determining the RBCs parameters and their correlation with renal function, and also the magnitude of anemia in DM patients in comparison with healthy controls. METHODS A comparative cross-sectional study was conducted at the chronic illness clinic of University of Gondar Hospital from January to April 2020. A total of 246 participants (164 DM and 82 controls) were selected using a simple random sampling technique. Data were collected using a pretested structured questionnaire. Five milliliters venous blood was collected by vacutainer blood collection technique. RBC parameters and renal function tests were determined by using Sysmex KX21N and BS-200E Mindray analyzers, respectively. The data were tested for normality using Shapiro-Wilk and Kolmogorov-Smirnov tests. Independent sample t-test and Pearson's and Spearman correlation statistics were used to analyze variables. A p-value ˂0.05 was considered as statistically significant. RESULTS The mean hemoglobin (Hgb) concentration was 13.8±0.7 and 15±1.3 among DM and controls, respectively. RBC (p=0.014), Hgb (p ˂0.001), hematocrit (Hct) (p ˂0.001), and mean cell volume (MCV) (p ˂0.001) were significantly lower in DM patients as compared to controls. On the other hand, mean cell hemoglobin concentration (MCHC) was significantly increased in DM patients (p ˂0.001) than the controls. Besides, a significant negative correlation was found between Hgb and creatinine (Cr) in DM patients. CONCLUSION The mean values of RBC parameters (RBC, Hgb, Hct, and MCV) for DM patients were found significantly lower than the control groups. Besides a significant negative correlation was found between Cr and RBC indices (RBC, Hgb, Hct, and MCV) in DM patients. It is, therefore, suggested that RBC parameters abnormalities should be evaluated and treated periodically in DM patients for better prognosis and quality of life.
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Affiliation(s)
- Tiruneh Adane
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Tiruneh AdaneSchool of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Sciences, University of Gondar, PO Box 196, Gondar, EthiopiaTel +251949914917 Email
| | - Zegeye Getaneh
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fikir Asrie
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Bekele A, Teji Roba K, Egata G, Gebremichael B. Anemia and associated factors among type-2 diabetes mellitus patients attending public hospitals in Harari Region, Eastern Ethiopia. PLoS One 2019; 14:e0225725. [PMID: 31805098 PMCID: PMC6894806 DOI: 10.1371/journal.pone.0225725] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 11/11/2019] [Indexed: 01/20/2023] Open
Abstract
Background Anemia is a common complication of diabetes mellitus, therefore having a major impact on the overall health and survival of diabetic patients. However, there is a paucity of evidence of anemia among diabetic patients in Ethiopia, particularly in Harari Region. Therefore, this study aimed to assess the magnitude of anemia and associated factors among Type 2 Diabetes Mellitus (T2DM) patients attending public hospitals in Harari Region, Eastern Ethiopia. Methods A hospital based cross-sectional study was conducted from February 25 to March 30, 2019. Probability proportion to size sampling, followed by simple random sampling, was utilized to select 374 T2DM patients. To collect the data, mixed methods were applied using questionnaires and checklist. Participants were tested for anemia based on World Health Organization (WHO) criteria. Data was double entered to EpiData version 3.1 and exported into Stata version 14.0 for statistical analysis. Bivariate and multivariate logistic regression models were fitted; Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were computed. Level of significance was declared at p-value less than 0.05. Results The study revealed 34.8% of the participants were anemic (CI: 28.7, 40.9). Being male (AOR = 2.92, CI: 1.65, 5.17), physical inactivity (AOR = 2.58, CI: 1.50, 4.44), having nephropathy (AOR = 2.43, CI: 1.41, 4.21), poor glycemic control (AOR = 1.98, CI: 1.17, 3.34), recent history of blood loss (AOR = 4.41, CI: 1.26, 15.44) and duration of diabetes for five years and greater(AOR = 1.72, CI: 1.01, 2.96)were all significantly associated with anemia. Conclusions Anemia was a major health problem among T2DM patients in the study area. Therefore, routine screening of anemia for all T2DM patients aiding in early identification and improved management of diabetes will lead to improved quality of life in this patient population.
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Affiliation(s)
| | - Kedir Teji Roba
- School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia
| | - Gudina Egata
- School of Public Health, Haramaya University, Harar, Ethiopia
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Fiseha T, Adamu A, Tesfaye M, Gebreweld A. Prevalence of anemia in diabetic adult outpatients in Northeast Ethiopia. PLoS One 2019; 14:e0222111. [PMID: 31498832 PMCID: PMC6733511 DOI: 10.1371/journal.pone.0222111] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 08/21/2019] [Indexed: 02/07/2023] Open
Abstract
Background Anemia is a common finding in patients with diabetes, even in the absence of kidney disease and is a risk factor for adverse outcomes, including all-cause and cardiovascular mortality. Despite this, relatively little is known about the burden of anemia among adults with diabetes in sub-Saharan Africa. The aim of this study was to determine the prevalence of anemia and its association with renal disease among diabetic adult outpatients attending a hospital in Northeast Ethiopia. Methods A cross-sectional study was conducted among 412 diabetic adults at the diabetes clinic of Dessie Referral hospital in Northeast Ethiopia, from January to April 2018. Each patient provided a blood sample for hemoglobin and serum creatinine levels and urine for albuminuria. Anemia was defined by World Health Organization criteria (<13 g/dl for men and <12 g/dl for women). Glomerular filtration rate (GFR) was estimated using the 4-variable Modification of Diet in Renal Disease (MDRD) equation. Chronic kidney disease (CKD) was classified into 5 stages based on the eGFR and albuminuria. Results Anemia was present in 26.7% of the participants, and CKD in 43.0%. Anemia was more prevalent in patients with CKD (39.5%) than those without CKD (17.0%; P < 0.001). The prevalence of anemia increased with stage of CKD, from 22.6% at stage 1 to 100% at stage 4. Fifteen percent of the patients had anemia below the treatment threshold of 11 g ⁄dl. In multivariate analysis, older age (AOR = 2.41, 95% CI 1.11–5.21); type 2 diabetes (AOR = 2.40, 95% CI 1.14–5.08); presence of hypertension (AOR = 3.78, 95% CI 1.35–10.57); high systolic BP (AOR = 1.05, 95% CI 1.02–1.08); serum creatinine (AOR = 12.80, 95% CI 3.90–87.98) and low GFR (AOR = 9.50, 95% CI 4.05–22.28) were independently associated with greater odds for the presence of anemia Conclusions Anemia is commonly present among diabetic adults attending our diabetes outpatient clinic in Northeast Ethiopia, including those without kidney disease. Our findings highlight the need for incorporating anemia screening into routine diabetes care to enable early detection and treatment of anemia and hence improve the overall care of patients with diabetes.
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Affiliation(s)
- Temesgen Fiseha
- Department of Clinical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- * E-mail:
| | - Aderaw Adamu
- Department of Clinical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Melkam Tesfaye
- Department of Clinical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Angesom Gebreweld
- Department of Clinical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Bishu KG, Jenkins C, Yebyo HG, Atsbha M, Wubayehu T, Gebregziabher M. Diabetes in Ethiopia: A systematic review of prevalence, risk factors, complications, and cost. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.obmed.2019.100132] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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AlDallal SM, Jena N. Prevalence of Anemia in Type 2 Diabetic Patients. J Hematol 2018; 7:57-61. [PMID: 32300413 PMCID: PMC7155869 DOI: 10.14740/jh411w] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 04/30/2018] [Indexed: 12/20/2022] Open
Abstract
Background The aim of the study was to determine the prevalence of anemia in patients with type 2 diabetes and to assess the risk of anemia according to gender, age and glycemic control. Methods The study group comprised of patients with type 2 diabetes attending Outpatient Diabetic Department of Amiri Hospital (Al-Asimah Capital area) from January 1, 2016 to December 31, 2017. Patients were divided into groups according to glycemic status and gender. Glycated hemoglobin (HbA1C) values and hemoglobin (Hb) levels were evaluated. The presence of anemia was defined by an Hb level < 13.0 g/dL for men and < 12.0 g/dL for women. Results The prevalence of anemia is significantly greater in diabetic females (38.5%) than in diabetic males (21.6%) and in poorly controlled diabetics (33.46%) than those with glycemic status under control (27.9%) (P < 0.05). The average age of patients with anemia was found to be 60.69 ± 0.198 years and the average age of patients without anemia was found to be 54.07 ± 0.121 years. This indicates that the risk of anemia increases with age. Conclusion Screening for anemia at the time of diagnosis of diabetes, diabetic medication compliance, awareness of the risk of anemia and other complications in the diabetic patients helps in reducing the prevalence of anemia in diabetic population.
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Anemia in type 2 diabetic patients and correlation with kidney function in a tertiary care sub-Saharan African hospital: a cross-sectional study. BMC Nephrol 2016; 17:29. [PMID: 26994993 PMCID: PMC4799843 DOI: 10.1186/s12882-016-0247-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 03/17/2016] [Indexed: 12/16/2022] Open
Abstract
Background Anemia is common in diabetic patients and increases morbidity and mortality, but its burden has been less well characterized in sub-Saharan Africans. We determined the prevalence of anemia and investigated the related factors, with a particular focus on the role of declining renal function, in type 2 diabetic patients attending a tertiary health care institution in Cameroon. Methods Hemoglobin (Hb) levels were measured in a consecutive sample of patients with type 2 diabetes, who reported for annual review at the outpatient section of the Douala General Hospital in 2013. Patients were classified as anemic according to the World Health Organisation criteria (Hb < 12 g/dl for females and Hb < 13 g/dl for males). Estimated glomerular filtration rate (eGFR) was calculated using the abbreviated Modification of Diet in Renal Disease Study Group formula. Determinants of Hb concentration and anemia were investigated using multivariable logistic regressions. Results A total of 636 patients were examined including 263 (prevalence rate 41.4 %) who had anemia. The prevalence of anemia increased significantly with deteriorating kidney function, although up to 31.9 % of patients with normal kidney function had anemia. Compared with their non-anemic counterparts, anemic diabetic patients were older, had longer duration of diabetes, lower eGFR, higher prevalence of proteinuria and diabetic retinopathy (all p < 0.05). In multivariable logistic regressions, eGFR (p = 0.001) and presence of retinopathy (p = 0.023) were the independent determinants of prevalent anemia. Conclusions The prevalence of anemia is high in type 2 diabetic patients attending referral institutions in Cameroon, including among those without chronic kidney disease. Routine screening for anemia in all diabetic patients may aid early identification and correction as appropriate.
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